艾司西酞普兰改善冠心病患者PCI术后抑郁症状对照研究

A comparative study of effect of escitalopram on depressive symptoms in patients with coronary heart disease after percutaneous coronary intervention

目的探讨艾司西酞普兰改善冠心病患者行冠状动脉介入手术(PCI)术后抑郁症状的疗效及安全性。方法将59例伴抑郁症状的PCI后的冠心病患者随机分成研究组(29例)和对照组(30例),研究组患者给予艾司西酞普兰系统治疗,对照组患者不接受艾司西酞普兰治疗,共治疗8周。在基线时及治疗后第2、4、8周末对两组患者行汉密尔顿抑郁量表(HAMD)和治疗中需处理的不良反应症状量表(TESS)评定。随访16周,对两组患者进行心血管不良事件评价。结果两组治疗后第2、4、8周末HAMD评分均低于各自基线时(P<0.05),研究组治疗后第2、4、8周末HAMD评分均低于对照组(P<0.05)。随访16周末,研究组心血管事件总发生率低于对照组(P<0.05)。两组患者总不良反应发生率比较,差异无统计学意义(P>0.05)。结论艾司西酞普兰可有效、安全地改善冠心病患者PCI术后抑郁症状,可在短期内减少患者术后心血管不良事件的发生。

Objective To explore the efficacy and safety of escitalopram in the treatment of depressive symptoms in patients with coronary heart disease after percutaneous coronary intervention（ PCI）. Methods 59 patients diagnosed as coronary heart disease after PCI with depressive symptoms were randomly divided into study group（ n = 29） treated with conventional therapy combined with escitalopram and control group（ n = 30） treated without escitalopram for 8 weeks. They were assessed with Hamilton Depression Scale（ HAMD） and Treatment Emergent Symptoms Scale（ TESS） at baseline and at the 2^nd,4^th and 8^th weekend of treatment. All patients were assessed with major adverse cardiovascular events after 16-week follow up. Results Scores of HAMD in both groups decreased significantly at the end of the 2^nd,4^th and 8^th week compared with the baseline（ P〈0. 05）. Scores of HAMD at the end of the 2^nd,4^th and 8^th week in study group were all significantly lower than those in control group（ P〈0. 05）. Incidence rate of major adverse cardiovascular events in study group was significantly lower than that in control group at the endpoint of follow-up（ P〈0. 05）. There was no significant difference in incidence rate of side effects between two groups（ P〈0. 05）. Conclusion Escitalopram is effective and safe for improving depressive symptoms in patients with coronary heart disease after PCI,and it can reduce the incidence of major adverse cardiovascular events for these patients within a short period.